by Chloe Evans, Multi-sector pre-registration pharmacist
As a pre-reg, my year was composed of two-month rotational placements in primary care, hospital, and community. I wasn’t 100% sure which area of pharmacy I wanted to go into once qualified, so this gave me a good insight into the role of pharmacists in different sectors. A key learning for me has been understanding the importance of supporting patient care pathways and the key role that pharmacy teams can play by supporting greater integration across sectors to support patients.
During my time in community pharmacy, I realised how important communicating with the patient and other health professionals is, particularly when patients are admitted to hospital. For those on weekly medicine trays, we need to know whether medicines change at the hospital, but the community pharmacy wouldn’t necessarily know this. This changed my practice in the hospital, when doing meds reconciliation on admission. If the patient is on blister packs, I would make sure to ring the community pharmacy to let them know that the patient is in hospital so they can wait for the discharge to see if there are any changes before sending out/making up the blister packs.
I also noticed the patient benefit of having a discharge medicines review with the pharmacist in primary care or as part of the community pharmacy discharge review service. I got the chance to do medicines reconciliations using the patient's discharge from hospital. The main challenge of supporting patients with their discharge in the community pharmacy is knowing about it and obtaining a discharge advice letter. This was an important lesson that I was then able to share with the hospital team.
A huge benefit from my hospital and primary care placements was that it improved my confidence when interacting with other healthcare professionals. It reinforced the importance of multidisciplinary working and gave me greater insight into their roles and when and how to refer and signpost. As my knowledge of community pharmacy grew, I was also able to support other healthcare professionals to refer into services such as the common ailment scheme, smoking cessation and the sore throat test and treatment. This better utilises community pharmacists’ skills and improves the patient care pathway.
There have been some challenges with the heavy workload because of the many ways of working. Also, the pandemic has meant that a lot of shadowing opportunities and consultations with patients couldn’t happen or had to be over the telephone. This is no fault of the programme, just a challenge of the pandemic.
The integrated programme has certainly helped me gain a good insight into the wide range of pharmacist roles. I am pleased that I chose a multisector placement as it has supported me to work in a multidisciplinary way and support the many pathways of patient care.
Wales is leading the way for Pre-Registration training in the UK. The new multi-sector model of Pre-Registration pharmacist training contributes to the building of a flexible pharmacy workforce with the skills and competence to deliver the vision of “Healthier Wales”: a workforce that can work, communicate and understand the whole patient care pathway which is essential for the efficient management of patient services.
Do you want more information about the integrated pre-registration programme in Wales? Want to hear more from trainees? Please visit HEIW for more information here.